Healthcare Provider Details

I. General information

NPI: 1053317958
Provider Name (Legal Business Name): BASIN COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 03/12/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NAT WASHINGTON WAY
EPHRATA WA
98823
US

IV. Provider business mailing address

PO BOX 65 200 NAT WASHINGTON WAY
EPHRATA WA
98823
US

V. Phone/Fax

Practice location:
  • Phone: 509-764-7474
  • Fax: 509-764-7480
Mailing address:
  • Phone: 509-764-7474
  • Fax: 509-764-7480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORA RENEE HOLT
Title or Position: LICENSED MENTAL HEALTH COUNSELOR/OW
Credential: LMHC
Phone: 509-764-7474